Syncapone 15037.5mg+200mg+150mg

• Parkinson's disease (with end-of-dose motor fluctuations)

Adults: Each tablet contains levodopa and carbidopa in a 4:1 ratio and entacapone 200 mg (Stalevo 50/75/100/125/150/200).

Initial dose: 1 tablet/day. Titrate dose according to patient's response.

Per dose: Only 1 tablet per dose administration is recommended.

Maximum dose: 8 tablets/day (maximum 2000 mg entacapone/day).

Hepatic impairment: Severe: Contraindicated; Mild-moderate: Caution, dose reduction may be needed.

Renal impairment: Severe (including dialysis): Caution required.

Elderly: No dose adjustment required.

Children: Safety and efficacy not established.

Transfer instructions: Patients on entacapone and levodopa/carbidopa can be transferred to equivalent tablets. Direct switch for patients not on entacapone is not recommended; initiate entacapone separately first.

Common side effects: Dyskinesia (abnormal movements), nausea, hyperkinesia, urine discoloration (red/brown/black), diarrhea, abdominal pain, constipation, headache, dry mouth, insomnia, orthostatic hypotension, anxiety, dizziness, abnormal dreams.

Serious (rare): Diarrhea (sometimes severe, colitis), hallucinations, other mental disturbances, rhabdomyolysis, neuroleptic malignant syndrome (fever, muscle stiffness, confusion), fibrosis, skin cancer.

Urine may become red, brown, or black (harmless).

• May cause dizziness and sleepiness; caution when driving or operating machinery.
• Avoid high-protein meals (meat, poultry, dairy products) as they reduce levodopa absorption.
• Do not stop suddenly (may cause serious syndrome: fever, muscle stiffness, abnormal movements, sweating, confusion).
• Inform your doctor if you develop hallucinations or behavioral changes.
• Periodic evaluation of hepatic, hematopoietic, cardiovascular, and renal function is recommended during extended therapy.
• Caution during pregnancy and lactation; do not breastfeed during treatment.